title: Pectoralis major myocutaneous flap for reconstruction of circumferential pharyngeal defects.
abstract: BACKGROUND
  A 270-degree partially tubed pectoralis major myocutaneous flap (PMMF) is an excellent option for total circumferential pharyngoesophageal defects in patients who are not candidates for more complex reconstructions.
  
  
  METHODS
  Patients undergoing circumferential pharyngoesophageal reconstruction with partially tubed PMMF were reviewed. End points were stricture, fistula, resumption of oral intake, perioperative death, and recurrence.
  
  
  RESULTS
  Eleven patients underwent 270-degree PMMF for reconstruction: 6 (55%) were men and 5 (45%) were women (mean, 62 years; range, 42-78 years). Three patients (27%) developed fistulas and 2 (18%) developed stenosis. Ten patients (91%) were able to resume adequate nutrition via oral intake. There were no perioperative deaths.
  
  
  CONCLUSIONS
  Patients with severe comorbidities, metastatic disease, a lack of donor vessels, or a potentially hostile abdomen may not be ideal candidates for free tissue transfer. For these patients, partially tubed PMMF using the prevertebral fascia provides a reliable alternative for reconstruction with excellent functional results.
authors.affiliation: From the Erie County Medical Center; Roswell Park Cancer Institute; and The State University of New York, Buffalo, NY.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Burke
authors.forename: Seth E
authors.initials: SE
authors.lastname: Kaplan
authors.forename: Lee J
authors.initials: LJ
authors.lastname: Kaplowitz
authors.forename: Maria M
authors.initials: MM
authors.lastname: Lotempio
authors.forename: Wesley L
authors.initials: WL
authors.lastname: Hicks
authors.forename: Nestor R
authors.initials: NR
authors.lastname: Rigual
authors.forename: Saurin R
authors.initials: SR
authors.lastname: Popat
authors.forename: Paul I
authors.initials: PI
authors.lastname: Tomljanovich
authors.forename: Thom R
authors.initials: TR
authors.lastname: Loree
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D004947:Esophagus / Q000601:surgery; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery*; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged; D064827:Myocutaneous Flap / Q000637:transplantation*; D010369:Pectoralis Muscles / Q000637:transplantation*; D010610:Pharyngeal Neoplasms / Q000601:surgery*; D010611:Pharyngectomy; D010614:Pharynx / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome